National Provider Identifier

Marissa Paige Macdonald, PA-C

Marissa Paige Macdonald, PA-C is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Lake View, NY and a listed phone number of (716) 912-3514.

NPI 1962397331Lake View, NYMedical Physician Assistant

Profile Overview

NPI
1962397331
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
June 09, 2025
Last Updated
June 09, 2025

Practice Location

  • 6496 Hackberry Dr
  • Lake View, NY 14085-9578

Phone: (716) 912-3514

Specialties

  • Medical Physician Assistant (363AM0700X)
Full Record
NPI
1962397331
Entity Type
Individual
Last Name
Macdonald
First Name
Marissa
Middle Name
Paige
Credential
PA-C
Mailing Street Address
6496 Hackberry Dr
Mailing City
Lake View
Mailing State
NY
Mailing ZIP Code
14085-9578
Mailing Country
US
Mailing Phone
(716) 912-3514
Practice Street Address
6496 Hackberry Dr
Practice City
Lake View
Practice State
NY
Practice ZIP Code
14085-9578
Practice Country
US
Practice Phone
(716) 912-3514
Enumeration Date
June 09, 2025
Last Updated
June 09, 2025
Sex
Female
Sole Proprietor
Yes
Certification Date
June 09, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X)